An investigation into the low COVID numbers in Telangana has revealed that the test results are being manipulated at the Public Health Centre (PHC) level.
Cooked up names, addresses, phone numbers and fake positive cases were revealed in the months long investigation. Out of the test data of 352, of randomly picked test cases between September and December, about 110 had suspect information.
“We have been given a target of 60 tests per day. We are not getting so many people so we are taking the help of Accredited Social Health Activist (ASHA) staffers to mobilise patients for the tests,” said a lab technician in a PHC. Four ASHA workers were seated near him working on their phones. Their job was to provide a name, an address and a phone number on which a 4-digit code is generated by the Aarogyasri server accessed by the lab technician.
The testing protocol deployed by the Telangana Health department for Rapid Antigen Tests is a seamless affair with the patient walking in giving the name, address and phone number. “Once the phone number is given, an OTP is sent to the number which generates a 15-digit unique identity of the patient. This data is automatically uploaded on the server,” said the staffer.
This streamlined process has been gamed by the health officials chasing targets as documented by fake tests and even a couple of false positive cases, the investigation revealed.
When this reporter underwent a test, the result was orally informed within 15 minutes and an online report was shared on the cellphone within 86 seconds. This is a massive change from the time when tests were conducted only with a doctor’s prescription and the results were made available after 24 hours.
The target test number varied across the PHCs between 50 and 60, while the area hospitals have been set a target of 200 tests per day.
Data collected on random dates in August, September, October and December showed multiple registrations using same phone numbers and addresses at one of the centres.
Even on days when people stayed indoors due to flood havoc in October, the numbers remained constant. Even on GHMC election day on December 1, 60 people got the test done at the centre.
On one day, a phone number was used by a patient called Asad, a few days later the same number was used by Anagha (names changed to protect patient confidentiality). Another give away was the repetitive nature of door numbers used for logging the tests.
On December 3, out of the 5,003 tests done in the GHMC area, 141 were positive and the positivity rate was 3%. But strangely, the day’s media bulletin shows only 109 positive results.
“If testing is not robust, the risk for the society will be higher as pre-symptomatic and asymptomatic carriers will be on the street. This will affect the vulnerable. Each such carrier can transmit it to three or four persons creating a ripple effect,” said Dr. B.R. Shamanna, who specialises in public health and teaches at the University of Hyderabad.
“Figures should not be manipulated if you think about the welfare of the people. We are dependent on 80% Rapid Antigen Test (RAT). Other states have done it differently by deploying RT-PCR in a major way giving those states and its citizens the correct picture about the prevalence,” said the public health policy expert.
“One of the likely long-term impact would be denial of vaccine. If the State’s case load is not high, the Central government officials might say, ‘you don’t need the vaccine’, then what?” he says.
Once the data is manipulated, contact tracing, a key element in fighting a pandemic like COVID, is just not possible.
Telangana has been having a problem with data right from the beginning of the pandemic. Between March 2 — when the first COVID-19 case was detected in Telangana — and June 17, the State averaged 429 tests per day. The numbers changed after the June 15 announcement that 50,000 tests would be conducted within the next 10 days in Hyderabad.
The director of public health could not be reached for a comment, when contacted.
